142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

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Reducing alcohol abuse is critical for treating HIV infection among vulnerable Black South African women

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014 : 12:30 PM - 12:50 PM

Irene Doherty, MPH, PhD , Substance Abuse Treatment Evaluations & Interventions, RTI International, Research Triangle Park, NC
William A. Zule, DrPH , Substance Abuse Treatment Evaluations and Interventions, RTI International, Research Triangle Park, NC
Jackie Ndirangu, MSC-GH , Substance Abuse Treatment Evaluations & Intervention Research Program, RTI International, Pretoria, South Africa
Wendee M. Wechsberg, MS, PhD , Substance Abuse Treatment Evaluations and Intervention Research Program, RTI International, Research Triangle Park, NC
Background: 

Heavy drinking is linked to sexual behaviors that increase HIV infection and transmission and reduces adherence to antiretroviral therapy (ART). Accordingly, brief behavioral interventions to reduce alcohol use among people receiving ART are a critical component of biomedical interventions such as HIV treatment as prevention.

Methods: 

A  clustered randomized field experiment funded by NIDA (R01 DA032061)

is being conducted across Tshwane, South Africa targeting Black South African women who use drugs or alcohol.  The experimental group receives an evidenced-based intervention to reduce sex risk, victimization, and alcohol and substance use and case management for linkages to care and treatment.

Results: 

To date, 430 women enrolled. Baseline HIV prevalence was 56% and 20% were newly diagnosed. There were no differences in demographic or risk characteristics between women were uninfected, previously or newly diagnosed.  Sex workers comprised 45% of the sample and 68% were HIV-infected.  Participants who drank alcohol in the previous 30 days (82%) consumed a mean of 12 drinks/day on the days that they drank.  On average, they drank 11 of the last 30 days and 89% of those days met criteria for binge drinking (>=4 drinks). 39% reported drug use when they drank.  There were no statistically significant differences in alcohol use by HIV status or by sex work.

Conclusions: 

Most women reached suffer from alcohol abuse. To help vulnerable women in South African townships reduce risk behaviors and adhere to HIV treatment, their alcohol use must be addressed.

Learning Areas:

Public health or related research

Learning Objectives:
Describe the extent of heavy alcohol use among sex workers and HIV-infected women in South Africa. Demonstrate the importance of treating alcohol abuse to prevent and treat HIV infection.

Keyword(s): HIV Interventions, Vulnerable Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a social epidemiologist and have served as principal or co-investigator on federally funded studies. My research addresses the effects of social and sexual networks on the spread of HIV, other sexually transmitted infections, and unintended pregnancy among underserved populations. MY past and current also examined alcohol and substance abuse, condom use, gender-based violence, sexual partnerships, HIV and STI transmission dynamics, and challenges in public health practice for STI control.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.